%0 Journal Article
%T Female Asthma Has a Negative Effect on Fertility: What Is the Connection?
%A Elisabeth Juul Gade
%A Simon Francis Thomsen
%A Svend Lindenberg
%A Vibeke Backer
%J ISRN Allergy
%D 2014
%R 10.1155/2014/131092
%X Reproductive changes such as impaired fertility and adverse pregnancy outcomes have been related to female asthma. We recently found that time to pregnancy is prolonged in asthmatic females especially in women with moderate to severe asthma and in those above 30 years of age. Despite their reproductive difficulties the asthmatics ultimately conceived just as many biological children as healthy throughout their reproductive lives. This knowledge therefore raises questions about how asthma affects fertility pathophysiologically. The purpose of this review is to describe the existing knowledge in this field and suggest hypotheses of causal relationships, which may form the basis for future studies in this field. The aim is, in particular, in the literature to examine whether there is any evidence to suggest that the systemic inflammation that characterizes asthma, can affect fertility. The issue is potentially clinically important for asthmatic, infertile individuals and society because treatment of the general systemic inflammation associated with the asthmatic disease combined with hormone stimulation might be the optimal target for an effective infertility therapy, possibly decreasing the need for in vitro fertilization. 1. Introduction We have recently, in a retrospective registry-based study, demonstrated that asthma significantly prolongs time to pregnancy (TTP) and thus fertility (21,6% versus 27% OR: 1.31 ), whereas allergy was not related to TTP [1]. Furthermore we showed that untreated asthmatics had a significantly increased risk of prolonged TTP compared with healthy individuals (30.5 versus 21.6%, OR =£¿1.79, ), while asthmatics receiving any kind of treatment for asthma tended to have a shorter TTP than untreated asthmatics (23.8 versus 30.5%, OR =£¿1.40, ) indicating that an untreated systemic inflammation could have a negative effect on fertility. These findings are to our knowledge new and of highly clinical relevance given that a large proportion of asthmatic patients are young and therefore in the reproductive age. The reasons for our findings are, however, unknown. The purpose of this review is therefore to provide an overview of the basic literature of the pathophysiology behind this finding and to suggest hypotheses on causal relationships. So far only few other studies have examined this issue, and even so, the results have been conflicting as to whether asthma or other atopic diseases can affect fertility. Other recent studies by Carson et al. [2] and Harju et al. [3] suggest an association between subfertility, fertility treatment,
%U http://www.hindawi.com/journals/isrn.allergy/2014/131092/